More People Landing in the ER After Abusing Muscle
THURSDAY, Nov. 3 (HealthDay News) -- The number of people
winding up in the emergency room because of the misuse or abuse of
the prescription muscle relaxant carisoprodol has more than
doubled, a new federal report warns.
Between 2004 and 2009, such visits went from 15,830 to 31,763,
investigators from the U.S. Substance Abuse and Mental Health
Services Administration (SAMHSA) found.
The sedative effect of carisoprodol (sold as Soma, Soprodal or
Vanadom) is useful when taken properly for the short-term relief of
acute muscle pain, but it can become dangerous when combined with
other prescription drugs, recreational drugs or alcohol. SAMHSA
officials noted that the vast majority of carisoprodol-related ER
visits during the study period involved at least one other
"We're not talking about an epidemic, but we are talking about a larger number of people ending up in the ER with misuse of this medication," said Peter Delany, director of SAMHSA's Center for Behavioral Health Statistics and Quality.
"Either they're prescribed it, or they get it from other people," Delany noted. "But, either way they think it's a safe drug, in the sense that it's not heroin or something like that. But it is a drug. And if it's misused, it can be a problem."
In the report, the SAMHSA team explained that when carisoprodol
is ingested, it is converted by the liver into a chemical with
anti-anxiety properties. This means that, even when taken on its
own, patients run the risk of developing a physical and/or
The U.S. Food and Drug Administration has therefore recommended
that patients take the medication only for limited periods of time
(two to three weeks). If taken in tandem with narcotic painkillers,
other anti-anxiety medications or alcohol, carisoprodol's sedative
effect ratchets up markedly, they added.
Despite these dangers, the drug is not currently classified by
the federal government as a controlled substance.
Among the report's highlights: ER visits related to carisoprodol
misuse were up across all age groups.
The most dramatic bump was seen among patients over the age of
50, whose visits tripled in the study period (from nearly 2,100 to
more than 7,100 visits). Visits among those aged 35 to 49 roughly
doubled (from more than 6,300 to more than 12,000).
More than three-quarters (77 percent) of carisoprodol-related ER
visits due to either abuse or misuse involved at least one other
prescription drug. Narcotic painkillers were the most common
additional medication, found among 55 percent of visits.
Benzodiazepines were the second most common, found among 47 percent
About 18 percent of visits involved carisoprodol alone, but
one-quarter involved a second drug, and one-third involved two
additional medications. Roughly 12 percent of ER cases involved
three other drugs, while another 12 percent involved another four
or more. Alcohol was implicated in 12 percent of
carisoprodol-related ER visits.
What's more, over one-third of all the misuse and abuse visits
(35 percent) required hospitalization of the incoming patient, the
The SAMHSA team concluded that though carisoprodol abuse and
misuse in the United States continues to be a relatively small
problem, it is one that is notably on the increase.
"But in many ways this is really a provider concern," Delaney added. "So I would say that providers, whether they're prescribing it or seeing patients in the ER, need to be aware of what's going on. And they need to be asking questions, so they're really making sure that a person isn't mixing substances in a way that's going to be causing problems."
Dr. Michael Brodsky, psychiatrist at the UCLA David Geffen
School of Medicine, suggested that the SAMHSA report is both
sobering and worrisome.
"First of all, doctors are by and large aware that this is a problematic medication," he said. "Short-term use for the relief of an acute muscle injury is a very reasonable thing to do. In fact, it probably speeds up the healing process. But it's relatively addictive. Not as much as cigarettes. But addictive in the way that you might say Michael Jackson was addicted to sleep medicine," explained Brodsky, who is also medical director of the Bridges to Recovery program in Pacific Palisades, Calif.
"Which means that, typically, people start taking it innocently. They have an injury, so they get a 10- or 14-day prescription. And they like the effect. They feel calm. They sleep well. They may even get a subjective sense of emotional well-being," Brodsky added. "And so they continue it inappropriately, and often combine it with other medications, particularly other sedatives. In that way it's very similar to the problem with traditional prescription painkillers like codeine, Vicodin, Percocet, or morphine," he noted.
"So this report is not a good sign, because it suggests that the upswing in the abuse of this drug is part of a tidal wave of change, a shift away from concern over illicit drugs to a major concern over prescription drug uses, misuses and abuses. It's definitely not good news," Brodsky said.
For more on carisoprodol, visit the
U.S. National Institutes of Health.
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